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The resurgence of universal mask guidelines is missing a critical point

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Entrance door of DTW terminal building with sign requiring masks. - GG5795 / SHUTTERSTOCK.COM
  • gg5795 / Shutterstock.com
  • Entrance door of DTW terminal building with sign requiring masks.

The delta variant is precluding the “hot vax summer” we were all promised — that is, all of us who chose to get vaccinated.

Cases are up nearly three-fold over the past two weeks, and hospitalizations and deaths are following suit. Though cases are up in all 50 states, they’re being driven by spikes in communities with low vaccination rates. Last week, case growth was three times higher in states where less than half of the population was vaccinated. Missouri, Arkansas, Alabama, and Louisiana — states where right-wing anti-science ideological opposition has hardened “vaccine hesitancy” into full-on vaccine opposition — are epicenters.

Though there have been reports of breakthrough infections among vaccinated people, it’s rare that these infections are symptomatic, let alone cause serious illness. A full 97% of hospitalizations or deaths are among the unvaccinated.

As Centers for Disease Control and Prevention Director Rochelle Walensky called it, this is, indeed, a “pandemic of the unvaccinated.” Yet, in response, local officials are calling for a return to universal mask mandates — for the unvaccinated and vaccinated. Los Angeles County, the most populous in the country, reinstituted their universal mandate last week — after it had been lifted for nearly a month.

Make no mistake, masks have been and continue to be one of the most important tools in the public health arsenal against this pandemic. They are the best way to prevent COVID-19 transmission — aside from vaccination. Which is why universal mask mandates are such a curious policy response. Of course it makes sense to require masks for people who are not vaccinated — but why require them among the vaccinated? This is a misstep.

Universal mask mandates rest on the misplaced assumption that the people for whom masking policy is most important — the unvaccinated — give a damn what public health officials have to say in the first place. This assumption was implicit in the CDC’s original guidance surrounding masking among the vaccinated; because of the furor over masks that had preceded their policy, some thought that the announcement allowing vaccinated people to take off their masks would incentivize vaccine holdouts to get vaccinated. It did just the opposite — it gave them carte blanche to go unvaccinated and unmasked. The CDC, like local officials pushing universal mask mandates now, overestimated its own influence. Those who are choosing not to get vaccinated today were choosing not to wear masks before that — after all, the outright vaccine opposition in the hardest-hit right-wing communities emerges from an anti-science ideology that dismisses the virus and the pandemic in the first place.

Public health officials are undercutting what authority they do have. The back and forth, on-again, off-again mask policy leaves them looking indecisive and divided. It also threatens to exhaust the public will. It threatens compliance today and could undercut future mask mandates, should they be necessary if a new variant arrives that is, indeed, vaccine-resistant.

There’s another risk. Requiring masks among the vaccinated falsely signals that vaccines aren’t as protective as they actually are, which undercuts the incentive to get vaccinated in the first place. That’s exactly the opposite of what we need, given that our best hope at finally bringing this pandemic to an end will be through achieving enough vaccination to approach some semblance of herd immunity. It’s also critical to protecting those who can’t get vaccinated, like children and immunocompromised people.

So what’s the likely outcome of new universal mask mandates? Vaccinated people who believe in science masking up while unvaccinated people remain maskless — and unvaccinated. Rather than universal mask mandates, we need vaccine verification that requires people to either vax up or mask up.

In response to rising case rates in France, President Emmanuel Macron announced a sweeping new policy requiring evidence of either COVID-19 vaccination or a negative PCR test to gain entry into government buildings and cultural centers like bars, restaurants, and museums. Within 24 hours of the announcement, 1.7 million people booked vaccination appointments. Nearly a million were vaccinated in one day — a national record.

But there’s also been public outcry. Thousands took to the streets to oppose what they called a violation of their civil liberties. Some compared themselves to Jews forced to wear Stars of David in Nazi Germany. But the historical inaccuracy and shrillness of these protests highlight what’s really at stake. This isn’t about discrimination — vaccine resistance isn’t an identity, after all. A small group of people whipped into hysteria over conspiracy theories and lies are now painting themselves as victims because the government has stepped in to stop them from holding the rest of their country hostage to this pandemic.

Anti-vaxxer hysteria would be far more pronounced in the U.S., making federal vaccine verification nearly impossible — if not practically, then politically. The Biden administration has already affirmed that it will steer clear of a federal verification mandate.

That said, short of mandating vaccine verification, there’s a lot that can be done to facilitate them. Private organizations are shying away from vaccine verification for employees over the risk of lawsuits. Though the Equal Employment Opportunity Commission has indicated that employers can require vaccine verification, there remains a lack of clarity about this. The EEOC would do well to project their ruling far more broadly. In addition, a rising number of customer outbursts over masking — such as on airplanes — has businesses worried about customer behavior, should they institute vaccine verification. The Justice Department could be quicker to action and more forceful in prosecuting these kinds of disruptions. “Law and order,” after all.

There is, of course, a tragic irony in all of this. At core, the same anti-science ideology that fashions itself as the protectors of “law and order” also claims to believe in “liberty and freedom.” When it comes to vaccines, masks, and the public good in the midst of a pandemic, they are yet robbing all of us of our liberty and freedom while rejecting the very basis of law and order — that the government has a responsibility to protect us in times of danger. Right now, that means getting more vaccines in arms. A return to universal masking won’t do that, but vaccine verification just might.

This article was originally published July 22 in The Incision. Get more at incision.substack.com.

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